血清ALT与慢性乙型肝炎、肝硬化FibroScan~弹性值动态检测结果的相关性

梁携儿; 张琪; 陈永鹏; 侯金林

血清ALT与慢性乙型肝炎、肝硬化FibroScan~弹性值动态检测结果的相关性

南方医科大学南方医院感染内科

基金项目:

南方医院新业务新技术课题(2009007)；

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中图分类号: R512.62
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出版历程
- 出版日期: 2010-05-20

The correlation of serum alanine aminotransferase level and liver stiffness measurement ( FibroScan) in patients with chronic hepatitis B flare

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摘要

摘要: 目的探讨肝脏弹性值(LSM)在慢性乙型肝炎发作过程中的变化及ALT对LSM影响。方法 43名慢性乙型肝炎感染者,包括慢性乙型肝炎(CHB)23人、肝炎肝硬化(LC)20人;入院时行腹部B超检查,住院期间每7～10天、出院后每1～3月行Fibroscan(FS)检测,同时行常规血液指标化验。结果 CHB组中LSM与ALT有显著相关性(r=0.324,P=0.004),偏相关分析提示LSM与ALT无统计学相关性(r=0.190,P=0.098);随ALT下降,LSM逐渐降至诊断肝硬化界值14.6 kPa以下,呈现持续下降、先升后降或下降后波动等三种模式。LC组中,LSM与ALT无统计学相关性;在ALT好转的11例中,LSM较入院当天下降(P=0.003),但仍高于肝硬化临界值。结论在非肝硬化CHB患者中,LSM受ALT水平影响较大。动态观察单一患者ALT与LSM变化,可能提高LSM预测肝纤维化准确性。
- 肝炎,乙型,慢性 /
- 肝硬化 /
- 丙氨酸转氨酶
Abstract: Objective To investigate the dynamic changes of liver stiffness measurements (LSM) in patients with chronic hepatitis B (CHB) flare and evaluate the relationship between LSM and alanine aminotransferase (ALT) .Methods Forty three patients with CHB flare were enrolled and divided into two groups according to clinical data and imaging modalities: CHB group (n = 23) and liver cirrhosis group (LC, n = 20) .Fibroscan was performed every 7-10 days during hospi-talization and every 1-3 months for outpatients follow-up.Abdominal ultrasound examination, hematology tests and liver function examinations were performed during hospitalization.Results In CHB patients, there was significant correlation between LSM and ALT (r = 0.324, P = 0.004) , whereas there was no statistically significant difference according to the partial correlation (r = 0.190, P = 0.098) .Following with continuously declined ALT, LSM fell down to lower than cirrho-sis cut-off value 14.6kPa with three distinct patterns;decrease, increase and then decrease with an irregular pattern.In LC patients, there was no significant correlation between LSM and ALT (r =-0.075, P = 0.565) .Although LSM signifi-cantly declined in 11 patients after drop in ALT (P = 0.003) , it was still higher than cirrhosis cut-off value.Conclusion The LSM value is largely affected by ALT in patients with non-cirrhotic CHB.Dynamic detection of LSM associated with ALT level would improve the diagnostic accuracy of FibroScan  scaning.
- hepatitis B /
- chronic /
- liver cirrhosis

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参考文献(14)

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